April 25, 2011
One of your guests is complaining of having difficulty breathing and you are several hours from the nearest port. You contact your medical service provider and the doctor instructs you to get the patient’s baseline vitals.
You may wonder why the doctor needs this information, but think of the doctor on the other end of the phone as a detective solving a mystery. The doctor needs you to provide clues to figure out what is wrong.
One of the vital signs you will be asked for is the patient’s pulse. Pulse is the same as heart rate. In a healthy adult, pulse is between 60 and 100 beats per minute. You can manually check the patient by either the carotid or radial pulse.
The carotid is the artery in the neck between the wind pipe and neck muscle, just under the jaw bone. To check the pulse here, place your index and middle finger on the patient’s Adam's apple, trace over to the side of the neck and press firmly just under the jaw line until you locate the carotid artery.
The radial pulse is found in the artery on the inside of the wrist, the thumb side. Again, place your index and middle finger on the patient’s wrist and feel for the radial pulse.
To get an accurate rate, count the number of beats you feel for 15 seconds, then multiply that number by four to get the pulse (beats per minute).
You should practice finding these pulse places on yourself from time to time. If you can find and count your own pulse, then doing it on someone else will be easier.
Sometimes finding and counting another person’s pulse can be challenging. There are two relatively inexpensive devices that can do this for you. The first is a digital or automatic blood pressure monitor, which ranges in price from $25 to $500.
The second is a pulse oximeter, commonly called a pulse ox. A pulse oximeter is a non-invasive medical device that can monitor the oxygen saturation of your patient's blood as well as their pulse.
A pulse oximeter slips on the patient’s finger (it does not hurt) and sends two beams of light across the nail bed. Inside the clip are two diodes, one emits a red light, the other an infrared light. These beams detect the color of the arterial blood, which calculates oxygen saturation.
Because a pulse oximeter is easy to use and provides fast results they play a vital part in emergency medicine. Often these are very useful when working with patients with respiratory or cardiac problems.
Paramedic Rick Sosa with Stuart (Fla.) Fire Rescue uses the pulse oximeter on every patient to obtain vital statistics. The information from the pulse ox provides the general condition of the patient and lets paramedics know if the patient’s condition is improving, declining or unchanged.
Prices vary on these units from a low of about $30 up to thousands of dollars. If you have a telemedicine device onboard, it should include a pulse oximeter. If you are not sure, now is a good time to open your telemedicine unit or your first aid kit to see what you have.
A healthy person should have oxygen saturation of 95-99 percent. These numbers vary with age, health, altitude, and if the patient is connected to an oxygen tank.
Please note: The pulse oximeter will not provide accurate oxygen saturation information if the patient has been exposed to carbon monoxide, and it may not perform well on patients with circulation issues, irregular or weak pulse rates, or in a brightly lit areas since this device uses light to measure.
About the Author
